Clinical evaluation of the effectiveness of a therapeutic and preventive approach in pregnant women with periodontal disease

Abstract

Background. Periodontal disease is one of the most common dental conditions among women of reproductive age, and its prevalence increases during pregnancy due to hormonal, immune, and microcirculatory changes. The significance of this issue is heightened by the link between periodontal infections and pregnancy complications, as well as adverse outcomes for the newborn. Furthermore, the course of the disease is exacerbated by the presence of chronic gastritis with iron-deficiency anemia, which causes tissue hypoxia and a decrease in local immunity.

Aim. To clinically evaluate the efficacy and safety of the developed therapeutic and preventive regimen in pregnant women with periodontal disease complicated by chronic gastritis and iron-deficiency anemia.

Materials and methods. A total of 39 pregnant women in the second trimester of gestation were examined and divided into a main group (n=14) with concomitant chronic gastritis and iron-deficiency anemia and a comparison group (n=25) without significant somatic pathology. Periodontal status was assessed using the OHI-S, PMA, PI, SBI, CPITN, Silness–Löe, and Green–Vermillion indices; periodontal pocket depth, loss of clinical attachment, salivation rate, and oral fluid pH were also measured. Observations were made prior to treatment, 4 weeks after treatment, and 3 months after treatment completion. Statistical analysis was performed using SPSS v.26.0 software, employing Student’s t-test, the Mann–Whitney U-test, and the Wilcoxon signed-rank test. Differences were considered statistically significant at p<0.05.

Results. It was found that in pregnant women with chronic gastritis and iron-deficiency anemia, the baseline periodontal status was significantly worse: the PMA index was 3.4 times higher than in the control group, and the CPITN index was 2.3 times higher (p<0.05). After application of the developed treatment regimen, a significant improvement in key clinical indicators was observed: a 61.2% reduction in OHI-S, a 68.4% reduction in PMA, PI by 66.5%, SBI by 68.0%, as well as a 25.4% reduction in periodontal pocket depth (p<0.05). The overall clinical efficacy of treatment in the main group was 91.7%, which significantly exceeded the results of standard therapy (p<0.001). Additionally, a positive effect on salivation rate and oral fluid pH was observed.

Conclusions. Chronic gastritis with iron-deficiency anemia significantly exacerbates the course of periodontal disease in pregnant women. The proposed therapeutic and preventive regimen is effective and safe, provides a statistically significant improvement in clinical and functional periodontal parameters, and can be recommended for clinical use.